We report a case of pneumoparotitis with extensive mediastinal emphysema. The patient was a 9-year-old boy who presented with swelling and pain on the left side of the cheek. Palpation revealed a snowgrasping feel on the cheek and neck. Computed tomography (CT) showed extensive emphysema, extending from the parotid gland and deep neck to the mediastinum, and we diagnosed pneumoparotitis with pneumomediastinum. The patient was started on treatment with antibiotics to prevent secondary infection and prescribed bed rest. The symptoms gradually disappeared and there was no recurrence of symptoms, suggesting the presence of pneumoparotitis. Pneumoparotitis is rare and can be diagnosed by clinical examination and imaging. For accurate diagnosis, otorhinolaryngologists should take a detailed medical history, and CT is effective for diagnosing, evaluating the disease progression, and deciding the appropriate treatment strategy.